Increased Use of Truvada for PrEP Linked to Declines in New HIV Cases

States with the highest utilization of PrEP had the greatest declines.

Results from a retrospective nationwide analysis on the impact of Truvada (emtricitabine and tenofovir disoproxil fumarate; Gilead) for pre-exposure prophylaxis (PrEP) showed that its use resulted in significant declines in new HIV infections in the US from 2012 to 2016. Findings from the study were presented at the 22nd International AIDS Conference (AIDS 2018) in Amsterdam.

Using the National HIV Surveillance System and national pharmacy data, researchers from Emory University Rollins School of Public Health and the Centers for Disease Control and Prevention (CDC) found that across the US, the prevalence in use of Truvada for PrEP increased from 7.0 to 68.5 per 1000 persons at highest risk for HIV during the 5-year period. In that same period, the rate of new HIV diagnoses among the general population decreased significantly from 15.7 to 14.5 per 100,000 persons.

States with the highest utilization had the greatest declines (pooled unadjusted estimated annual percent change [EAPC] of HIV diagnoses in the 10 states with highest use: -4.7%), while those with the lowest utilization, on average, saw an increase in new HIV diagnoses (EAPC in the 10 states with lowest use: +0.9%). Moreover, after controlling for state-level viral suppression, the rate of Truvada use for PrEP was still significantly associated with declines in new HIV diagnoses.

“These data further validate the potential for significant public health impacts of Truvada for PrEP to help reduce HIV transmission in the US,” said Patrick Sullivan, Professor of Epidemiology at Rollins School of Public Health, Emory University, and lead study author. “By documenting significant declines in average new cases of HIV in states where Truvada for PrEP has been most widely adopted, our analysis emphasizes the importance of improving access to HIV screening and a full range of prevention tools, including PrEP, in US states.”

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In the US, Truvada is approved for PrEP to reduce the risk of sexually acquired HIV-1 in high-risk uninfected adults and adolescents in combination with safer sex practices.